National Provider Identifier [NPI]: |
1255350674 |
Last Name Of The Provider |
HULL |
First Name Of The Provider |
KURTIS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7855 S EMERSON AVE |
Street Address 2 Of The Provider |
SUITE H |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462378668 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
1274 |
Number Of Medicare Beneficiaries |
212 |
Total Submitted Charge Amount |
162872.55 |
Total Medicare Allowed Amount |
97447.79 |
Total Medicare Payment Amount |
68580.52 |
Total Medicare Standardized Payment Amount |
74243.19 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
1601 |
Total Drug Medicare AllowedAmount |
431.93 |
Total Drug Medicare PaymentAmount |
422.34 |
Total Drug Medicare Standardized Payment Amount |
422.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1244 |
Number Of Medicare Beneficiaries With Medical Services |
212 |
Total Medical Submitted Charge Amount |
161271.55 |
Total Medical Medicare Allowed Amount |
97015.86 |
Total Medical Medicare Payment Amount |
68158.18 |
Total Medical Medicare Standardized Payment Amount |
73820.85 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
129 |
Number Of Male Beneficiaries |
83 |
Number Of Non Hispanic White Beneficiaries |
199 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.999 |